What is the difference between skin and nipple-sparing mastectomy and traditional mastectomy?
Traditional mastectomy removes the entire breast gland along with the overlying skin and nipple, resulting in significant physical loss for the patient. In both cases, breast reconstruction can be performed; however, skin and nipple-sparing mastectomy offers far superior aesthetic outcomes, as the external appearance of the breast is preserved.

In which cases can skin and nipple-sparing mastectomy be performed?
This procedure may be performed in selected cases of early-stage breast cancer, as well as in women at high risk of developing breast cancer (such as those with BRCA gene mutations) as a preventive measure. The decision regarding suitability is made by the breast surgeon in collaboration with the oncologist.

How is the procedure and reconstruction performed?
The surgery is carried out through an incision in the lower part of the breast (along the inframammary fold) or through an incision at the side of the nipple.
Through this incision, the breast surgeon removes nearly all of the breast gland while preserving the skin and nipple.
Subsequently, the plastic surgeon usually places a permanent silicone implant, often using a biological collagen mesh to provide additional support and protection for the implant.

How safe is this procedure from an oncological standpoint?
In cases of prophylactic mastectomy in high-risk patients, studies have shown that the risk of developing breast cancer is reduced from 85%–90% to less than 5% following this procedure. The small amount of tissue remaining beneath the nipple is carefully examined with intraoperative biopsies to ensure oncological safety — a practice supported by results from major centers in Europe and the United States.
For breast cancer cases where this procedure is indicated, strict criteria are applied, such as a small peripheral tumor located more than 2 cm away from the skin or nipple, estrogen receptor (ER) and progesterone receptor (PR) positive status without HER2 overexpression, or non-invasive tumors such as ductal carcinoma in situ (DCIS).

Are there any contraindications?
The success of this procedure depends on good blood supply to the breast skin. Therefore, patients who smoke or who have previously undergone radiation therapy to the area may be at increased risk of complications. These patients should discuss potential risks and available alternatives in detail with their surgical team.